Ectopic Pregnancy Symptoms & Causes

Ectopic Pregnancy Symptoms & Causes

Unfortunately for many women, the discovery of an ectopic pregnancy only happens during a scan, a time when they are hoping to get the first glimpse of their baby. Discovering that a pregnancy is ectopic is devastating, and it is expected that there will be many questions you would want to know the answer to.

Article Contents

Here we will discuss answers to questions such as; What is an ectopic pregnancy? What are the signs of ectopic pregnancy? What are the causes of ectopic pregnancy and what does ectopic pregnancy pain feel like. If you are in any way concerned about your pregnancy and believe it might be ectopic it is very important to consult with your mid wife or doctor for medical advice before worrying too much.

First Scan Image

Ectopic Pregnancy Symptoms

It is usually between the 4th and 12th weeks of a pregnancy that ectopic pregnancy symptoms will develop. However, many women notice some ectopic pregnancy symptoms at 6 weeks. At first, many women may not, in fact, experience any early signs of ectopic pregnancy.

They may only find out that there is an issue if they are sent for an early pregnancy scan, or later on when they develop more serious symptoms.

According to the ectopic pregnancy symptoms NHS page, the main symptoms to look out for are:

Vaginal bleeding – This will tend to be a little different to the bleeding you experience with a regular period and will often start and stop. It may also be darker brown in colour and may be watery.

It is often easy to mistake this type of bleeding for a normal period, especially if you don't suspect you are pregnant.

During pregnancy, vaginal bleeding is quite common and is not necessarily an indicator of an ectopic pregnancy, but it should always be checked out.

Tummy pain – you might experience low down tummy pain that is only on one side. It can come ion suddenly, gradually, come and go or even be more persistent.

There are many causes of tummy pain, including trapped wind and stomach bugs, so this kind of pain does not necessarily mean your pregnancy is ectopic; however, it is essential to get it checked out.

Shoulder tip pain - this is pain that is unusual and occurs where your arm begins, and your shoulder ends. While the reasons it occurs are not fully understood, it can be a sign that an ectopic pregnancy is causing some internal bleeding, and medical assistance should be sought.

Discomfort going to the toilet – this could be either from passing urine or a bowel movement. You may also experience diarrhoea.

Unfortunately, pregnancy can lead to some changes in your bathroom patterns, but it is important to seek advice just in case, especially if you have any of the other main symptoms of a possible ectopic pregnancy

Tummy Pain During Pregnancy

What is Ectopic Pregnancy?

An ectopic pregnancy is one in which the fertilised egg becomes implanted somewhere other than in the womb; ectopic means misplaced. Implantation may instead occur in one of the fallopian tubes, the cervix or the abdominal wall. 

The fallopian tubes are what connect the ovaries to the womb. When an egg becomes fertilised, it travels to the uterus in order for fertilisation to take place. In the case of an ectopic pregnancy, the fertilised egg does not make it to the womb.

Instead, it becomes "stuck" along the way. When this happens, the fertilised egg is unable to develop into a viable pregnancy, and your health is at risk if the pregnancy continues. In order to grow and become a viable pregnancy, a fertilised egg must implant in the womb.

If you are wondering “does an ectopic pregnancy show on a pregnancy test” the simple answer is that a pregnancy test will only show that you are pregnant, a scan is required to determine if your pregnancy is ectopic. There is no ectopic pregnancy test. A scan is the only way to confirm an ectopic pregnancy.

Unfortunately, a pregnancy that is confirmed as an ectopic one is not viable, and there is no way to save the pregnancy. Medical intervention in the form of surgery or medicine is usually required to remove the implanted egg.

Prompt treatment is vital and can help to reduce the risks of any complications as well as increasing the chances of a further healthy pregnancy later on. It can also help to reduce other health complications that are not pregnancy-related.

Ectopic pregnancy figures suggest 1 in every 90 pregnancies is an ectopic one. That means approximately 11,000 ectopic pregnancies occur in the UK every year.

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Ectopic Pregnancy Pain / How to Ease it

Pregnancy brings with it a whole new range of sensations and feelings, and it can be difficult to know which ones those are related to a normal pregnancy and which are not. If you are in any doubt at all about the symptoms you are dealing with, especially those that are causing you pain, then it is worth speaking to your doctor.

It is also worth remembering that symptoms will vary from one pregnancy to another, so do not be afraid to seek a medical opinion. Your doctor will be happy to dispel any fears that you may have or refer you for an early scan at the hospital if they are concerned in order to check for any problems.

Abdominal pain

It is not unusual to experience what is often described as period-like pain in the back and lower tummy during pregnancy. However, if your pain is persistent or intermittent, coming and going, and located on just one side of your stomach, it needs to be investigated.

Significant back pain and or lower abdominal pain should also be investigated as soon as possible. If you have any discomfort, combined with a feeling of fullness and bloating (that isn't as a result of eating) when you are lying down, and especially if you have already had a child you should also seek medical advice.

Shoulder tip pain

Ectopic pregnancy shoulder pain should also be taken very seriously. This is usually referred to as shoulder tip pain and:

  • Has begun suddenly
  • May be significant and in addition to other symptoms, ie. A general feeling of being unwell, vaginal bleeding, abdominal pain, bloating or fullness of the abdomen, pain when having a bowel movement, faintness.

Normal over the counter pain medication such as paracetamol can be taken to help with your symptoms, your doctor will advise you on this.

Medication during pregnancy

Ectopic Pregnancy Causes

One question that many women ask when they have had an ectopic pregnancy is How did this happen? Ectopic pregnancy causes are not always clear, which can be very difficult to accept. In some circumstances the following conditions have been linked to cases of ectopic pregnancy

  • Existing inflammation and scarring of the fallopian tubes
  • Infection to the uterus, fallopian tubes or ovaries
  • Surgery on one or both of the fallopian tubes
  • Some forms of abdominal surgery, for example, a Caesarean section or having your appendix removed
  • Hormonal conditions such as endometriosis or Polycystic Ovary Syndrome (PCOS)
  • Some fertility problems including IVF can result in an ectopic pregnancy
  • Certain forms of contraception, for example, the progesterone-only pill
  • Genetic abnormalities
  • Defects that occurred at birth
  • Certain medical conditions that can affect both the shape and condition of the fallopian tubes and other reproductive organs
  • A previous ectopic pregnancy – if you have had an ectopic pregnancy before your GP will usually order an early scan to check that this pregnancy is not ectopic

There are also some groups of women who are at a higher risk of having an ectopic pregnancy. These include:

  • Those women who smoke
  • Women who are aged over 35

Unfortunately, in some cases, it is simply not clear why a pregnancy was ectopic. Your medical practitioner will be able to discuss your ectopic pregnancy with you and may be able to give you some more specific information about your condition. Many women who have an ectopic pregnancy have no obvious cause and no known risk factors – and it is this that can make it especially difficult to come to terms with.

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Ectopic Pregnancy Scan

Because of its location, an ectopic pregnancy cannot be confirmed with an abdominal ultrasound scan. An ectopic pregnancy scan is more likely to be done transvaginally. Once a scan has confirmed it,  ectopic pregnancy treatment will be offered. This may take a variety of forms.

Expectant management – if the pregnancy is very small or cannot be located, then you will be monitored to see if more invasive treatment is required. In some cases, the pregnancy will dissolve on its own

Medication – a medication is sometimes prescribed to stop the pregnancy from growing. Methotrexate for ectopic pregnancy is given as a single injection. Sometimes if this does not work, a second dose is required. If it is unsuccessful, surgery will be necessary. Contraception is required for 3 months following this treatment as Methotrexate can be harmful to a baby.

Surgery – this method is used to remove the pregnancy and often the affected fallopian tube. Ectopic pregnancy surgery is keyhole surgery, carried out under general anaesthetic.   If you have a ruptured ectopic pregnancy, then immediate treatment is required, and emergency surgery is the only option.


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